A nurse is caring for a client who has developed a paralytic ileus related to acute pancreatitis and reports pain as 8 on a scale of 0 to 10. The client has prescriptions for multiple PRN pain medications. Which of the following medications should the nurse administer?

PO oxycodone

Ibuprofen via NG tube

IV hydromorphone

Topical lidocaine patch

Answer and Explanation

The Correct Answer is C

A. PO oxycodone: Oral medications are contraindicated in clients with paralytic ileus because of impaired gastrointestinal motility, which prevents proper absorption and increases the risk of gastric retention. IV administration is preferred for effective pain control in this scenario.

B. Ibuprofen via NG tube: NSAIDs can cause gastric irritation and increase the risk of gastrointestinal bleeding, especially in clients with pancreatitis. Additionally, an NG tube is not an appropriate route for medication administration in the presence of an ileus due to impaired intestinal function.

C. IV hydromorphone: IV opioids provide effective and rapid pain relief for clients with severe pain, especially when oral or enteral administration is not feasible. Hydromorphone is commonly used in acute pancreatitis because it controls pain effectively without exacerbating the underlying condition.

D. Topical lidocaine patch: While lidocaine patches provide localized pain relief, they are not sufficient for managing severe visceral pain associated with pancreatitis and ileus. Systemic analgesia via IV opioids is more appropriate for controlling this level of pain.

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Correct Answer is D

Explanation

A. Use fluticasone as needed for shortness of breath: Fluticasone is a corticosteroid used for long-term inflammation control in COPD, not for immediate symptom relief. Short-acting bronchodilators like albuterol are used for acute shortness of breath.

B. Limit fluid intake to 1 L per day: COPD clients benefit from adequate hydration (typically 2-3 L per day) to help thin mucus secretions and improve airway clearance. Restricting fluids can lead to thickened secretions and increased respiratory distress.

C. Avoid use of pursed-lip breathing: Pursed-lip breathing is encouraged for COPD clients to help reduce air trapping, improve oxygenation, and promote more effective exhalation. It is an essential technique for managing dyspnea.

D. Obtain a yearly influenza immunization: COPD clients are at higher risk of complications from respiratory infections. An annual influenza vaccine helps reduce the risk of severe illness and exacerbations, making it a crucial part of COPD management.

A. Provide a diet of fresh fruits and vegetables for the client. B. Apply new gloves when alternating between wound care sites. C. Clean the equipment in the client's room once per week. D. Limit visitation time for the client's children to 40 min per day.

Correct Answer is B

Explanation

A. Provide a diet of fresh fruits and vegetables for the client: While a high-protein, high-calorie diet is essential for wound healing in burn patients, fresh fruits and vegetables may not be appropriate if the client is immunocompromised due to the risk of bacterial contamination. Cooked or peeled produce is often recommended.

B. Apply new gloves when alternating between wound care sites: Burn wounds are highly susceptible to infection. Changing gloves between different wound sites prevents cross-contamination and reduces the risk of spreading bacteria, which is critical in preventing wound infections and sepsis.

C. Clean the equipment in the client's room once per week: Equipment in a burn unit should be cleaned and disinfected daily to minimize the risk of infection. Weekly cleaning is insufficient for infection control in an immunocompromised client.

D. Limit visitation time for the client's children to 40 min per day: While infection control is a priority, limiting visitation is not typically necessary unless the visitors are ill. Emotional support from family can aid in psychological recovery, and proper infection control measures can be implemented without strict visitation limits.

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A nurse is caring for a client who has developed a paralytic ileus related to acute pancreatitis and reports pain as 8 on a scale of 0 to 10. The client has prescriptions for multiple PRN pain medications. Which of the following medications should the nurse administer?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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